THA Health Sec: Make PrEP drug available

THA Deputy Chief Secretary and Secretary of Health, Wellness and Social Protection Dr Faith BYisrael says she fully supports an HIV/Aids activist’s public call for Government to change its policy and allow pre-exposure prophylaxis (PrEP) medication – which can prevent people from contracting HIV – to be easily and readily available to the general public.

BYisrael spoke to Newsday on Monday after the call by HIV/Aids advocate Ronaldo Castillo.

The 24-year-old activist, who has been living with the virus since he was a baby, told Newsday's Zainab Kamara in an interview that it did not make sense for government to have a policy that bans PrEP from wider general public use when this country has been a signatory since 2016 to the UNAids programme to eliminate the spread of the virus by 2030.

“I agree that we should provide both pre- and post-exposure treatment to the wider population. In the fight to prevent new HIV infections, we need to utilise all of the available resources,” BYisrael said.

She added that there are medications that can be taken before exposure – also known as pre-exposure prophylaxis – or after exposure – known as post-exposure prophylaxis – but they are given under controlled circumstances by the health authorities, for example, for a victim of sexual assault.

“We should also aim to treat every client with HIV to ensure they are undetectable or with very low levels of (the) virus in their bodies.”

These three methods, combined with robust HIV/Aids-related education, she said, will provide the best opportunity to reduce new infections and deaths.

At a function on Friday to commemorate World Aids Day, she said the levels of decrease in new infections are not seen in terms of the death rate.

“When we look at the numbers, we recognise that there is actually (growth) in terms of the number of people who are still contracting HIV. And this is so even at this point, when we have all of the information, because we have the condoms, because we have the education, because we have the medication.

“We should actually be at the point where, when you go to the drugstore, you are seeing the condoms, and they are being sold because we have the information pertaining to condom use.”

She said the same ought to apply for PrEP drugs.

She said it has been approximately 40 years since the virus was first detected in TT, yet stigmatisation remains deeply embedded, despite major advances in medicine that mean Aids is no longer a death sentence.

Many people, she said, are still very uncomfortable when it comes to speaking about sexual health and even sexuality in general.

“So when I do my talks on human sexuality, and I talk to parents, or I go into spaces where there are students, and there are parents and teachers, it is the parents and teachers who are the ones who look at me and kind of shake their heads, indicating we should not be talking about this.

“Well, I am saying to them, ‘You probably don’t want to talk about this, but remember, I am not the one who will ask the questions...it will be your 12- and 13-year-old child.’”

She said if parents and teachers are not prepared to answer these questions asked by young people, then this segment of society would seek answers elsewhere – and the answers they get may not be correct.

“If in 2023, I am still having pushback from parents, then we recognise and understand why we are still at the stage we are at right now when it comes to sexuality and sexual health being taboo subjects.”

She said Trinidad and Tobago must recognise the world has moved on and there is medication that can take the viral load down to medically undetectable levels.

BYisrael said her division is looking at partnering with NGOs and other groups to reduce the spread of HIV on the island.

“Those of you who are a part of youth groups and so on, we are throwing it out to you to try to come up with proposals (on) which we at the Division of Health, Wellness and Social Protection, and the Tobago Regional Health Authority can partner with you to ensure we continue providing the kind of information, outreach and education so people can take better precaution to prevent the spread of HIV.”

This transfer of knowledge, she said is necessary to ensure the reduction in the spread of the virus. She reiterated that minimising or stopping infections remains of paramount importance.

“Even though we seem to have so many successes as it relates to the treatment and care of people living with HIV/Aids, we are still nowhere near to where we need to be as it relates to the prevention of the spread of this virus.”

She also encouraged Tobagonians to get tested.

“There is no reason for us to have all of this medication, all of this technology, and you have HIV, and you do not make use of it. So we are encouraging all to go and get tested.”